Treatment of varicose veins

Varicose veins are a disease associated with the thinning of the vein wall, the increase in the diameter of the lumen of the veins, and the formation of aneurysm-like nodular expansions. Any vein can be affected, but it is more often diagnosed in the lower limbs. Treatment of varicose veins includes drug therapy and surgical methods. Lack of therapy increases the risk of dangerous complications.

Causes of varicose veins

The cause of the disease is not fully known. We can name only provocative factors that increase the risk of the development of pathology:

• genetic predisposition. If one of the parents had the disease, it can also develop in children.
• long static loads. Working in a standing position causes stagnation of blood in the veins, which leads to their expansion and the formation of varicose veins.
• Lack of movement.
• Excessive loads, including professional sports.
• Excess weight, which leads to increased pressure in the vessels of the lower extremities.
• Pregnancy, during which the pressure in the vessels of the pelvis and lower limbs increases, and the elasticity of the vessel wall also changes.
• Wearing high-heeled shoes, which interfere with the contraction of the calf muscles, which are involved in the flow of blood through the veins (the so-called "muscle pump").
• Improper nutrition (especially lack of fiber), which leads to constipation, which causes an increase in pressure in the vessels of the pelvis and lower limbs.
• Bad habits.
• Hormonal imbalances.

These are common causes of varicose veins. If in women the first signs of venous insufficiency appear during pregnancy or immediately after childbirth, then in men the disease usually appears after 40 years. The vessels of the legs are more often affected. The treatment of varicose veins of the lower limbs is practically the same for both sexes.

Symptoms of varicose veins of the lower extremities

Officially, the disease is divided into three stages:

1. Compensation.
2. Undercompensation.
3. Decompensation.

In addition, there is an international classification that distinguishes classes:

• C0. There are no signs of vascular damage, but the patient complains of varicose veins.
• C1. Dilation of small superficial veins can be observed.
• C2. Varicose veins are revealed during a visual examination.
• C3. The patient complains of tissue swelling, pain, and excessive fatigue after a working day.
• C4. The first symptoms of trophic disorders are determined visually.
• C5. Trophic changes appear, but the ulcers heal. There may be scarring.
• C6. Trophic changes are pronounced, there are active ulcers.

The degree of pathology is determined based on the results of visual examination, instrumental diagnostic methods and existing signs of chronic disease.

The first symptoms are:

• Increased leg fatigue.
• The swelling of the tissues, especially in the evening, goes away after a short rest.
• Feelings of pain.
• Characteristic heaviness in the legs.
• Nocturnal cramps in the calf muscles.
• Burning sensation along the vein.

The pain is particularly significant. It never radiates to the thigh or heel, but is always felt at the site of the affected vein and is painful in nature. The feelings are often exhausting and prevent sleep. After sleeping, the pain subsides.

In the initial stage, there are no signs of damage to the saphenous vein, but changes are already taking place. The process can take several years, so the treatment of varicose veins often begins when the pathology already has 3-4 classes. Over time, the clinic grows, and the severity of the symptoms of venous insufficiency increases:

• Increasing tissue swelling. It is mainly localized in the calf muscles. Like the pain, the swelling appears in the afternoon and disappears after a night's rest. It is important to distinguish edema of the calf muscles from swelling of the leg tissues. The latter indicates a violation of the outflow of lymph.
• Skin itching. It is noted along the vessels.
• Visual changes in the form of tortuous veins on the skin, the presence of extensions.
• Skin changes due to circulatory disorders. There is cyanosis, the tissues thicken, darkening is possible.

In the absence of therapy, the clinic is supplemented by signs of tissue malnutrition, the appearance of trophic ulcers, eczema, etc. Violation of venous valves can cause the following complications:

• Thrombophlebitis. It is characterized by blood clot formation. Without help, the condition is life-threatening.
• Venous thrombosis. Occurs with blockage of the vessel. It manifests itself in severe pain that worsens during physical activity.
• Pulmonary embolism. It is formed as a result of the separation of a blood clot. Due to its small size, the development of pneumonia or chronic heart failure is possible.
• Trophic ulcers. The first signs are thickening of the tissues above the affected vein. In addition, the tissues thin out and an ulcer appears. The focus does not heal for a long time and does not respond to therapy.

Diagnosis of the disease

Despite the typical symptoms, it is impossible to establish a diagnosis and start taking medication based only on the results of a visual examination.

Doppler imaging is mandatory. This is one of the easiest ways to assess the vascular system. It is based on determining the degree of change in the frequency of the sound signal reflected from the blood cells.

When the ultrasound is performed, angioscanning is performed, which makes it possible to assess the condition of the vessel wall and the direction of blood flow. The result will be a two-dimensional image of the veins, with the reflection of the valves and possible blood clots.

In the event that the listed methods do not provide an exhaustive answer, CT is prescribed. If thrombosis, angiodysplasia and damage to the veins of the small pelvis are suspected, radiopaque phlebography is prescribed.

Treatment of varicose veins on the legs

A phlebologist deals with the diagnosis and treatment of pathology. For this, you should consult a specialist at the first signs of illness. In advanced cases, when conservative therapy does not give the desired effect, radical methods are used. In this case, the vascular surgeon deals with the elimination of varicose veins.

Treatment methods are determined based on the results of the examination. In the initial stage, both general and local drugs can be used. If the drugs do not work, surgery is prescribed.

Conservative treatment

The main drugs are venotonics (phlebotonics). It is available in the form of tablets and capsules, which have a systemic effect. Thanks to them, blood circulation can be normalized and the condition of the whole body can be improved. In addition to tablets, you can also use local remedies with a similar effect. These are creams and gels. They have a pronounced effect, but the effect lasts for a short time.

The effect of phlebotonics is based on improving the elasticity of blood vessels, reducing the permeability of the wall and eliminating congestion. In patients, edema decreases and hematopoiesis normalizes.

The use of antiplatelet and anticoagulation agents is permitted. It is indicated with a high risk of blood clot formation, as well as in their presence. Thanks to them, it is possible to destroy blood clots and reduce viscosity. The bases are used for a pronounced violation of the viscosity of the blood, but cannot be used in case of bleeding risk.

In addition to the preparations, specialists prescribe compression stockings. It can be elastic bandages, socks, stockings, tights. The positive effect of their use can be explained as follows:

• The linen puts pressure on the affected varicose veins and deep veins.
• In the lower part of the legs, the blood vessels experience the most pronounced pressure of the knitwear, which eliminates congestion.
• The vessels are constantly compressed, so the operation of the valves becomes more efficient.
• When using underwear, the severity of edema and pain is reduced.

Methods of surgical treatment of varicose veins

In the absence of drug therapy, surgery is prescribed. The implementation is subject to the following conditions:

• Failure of conservative treatment
• The first signs of thrombophlebitis.
• Pronounced expansion of the vessel wall.
• Significant tissue swelling.

Varicose veins can be effectively treated with the following methods:

• Radiofrequency obliteration, which allows the restoration of the structure of blood vessels.
• Laser coagulation, during which the affected areas are affected by a laser.
• Varad technique with complete removal of the affected vessel.
• The Venaseal technique, thanks to which the valves of the veins stick together.
• Sclerotherapy, which makes it possible to "glue" the vessels from the inside.

Modern methods of treating varicose veins allow all the necessary procedures to be performed without hospitalization and the patient can be discharged home. The choice of technique is determined by the doctor based on the results of the examination.

Prevention of pathology

Varicose veins are difficult to treat, and even after surgery, preventive measures must be taken to prevent recurrence. Some patients use drug therapy and wear compression stockings throughout their lives. Pathology can be prevented as follows:

• Refusing to drag things away.
• Wearing shoes with medium heels.
• Complete nutrition.
• Weight control.
• Normalization of the drinking system.
• Active recreation, swimming, cycling.
• Rejection of bad habits.

Observance of preventive measures and an attentive attitude towards the body will help to prevent the disease and to notice the deviations in time. Timely treatment of varicose veins eliminates the progression of the pathology and the development of complications.